Nicole Ann Keen, LICSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

7401 Metro Blvd Ste 250
Edina, MN 55439-3062

Phone

(773) 648-3928

NPI assigned

Jul 1, 2021

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1134799026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 BELVIDERE ST E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072404",
            "telephone_number": "773-648-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 METRO BLVD STE 250",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554393062",
            "telephone_number": "773-648-3928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6636 Cedar Ave S Ste 360",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554232712",
            "country_code": "US",
            "telephone_number": "773-648-3928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEEN",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KC Core MN PLLC (KC Core)
• John Robert Kearns, M.D.
• Kristen Pearl Kearns, LPCC
• Brian Todd Keasling, ATC
• Maria Andersen Keeler
• Kaitlin M Keeney
• Simon Keepers
• Kehle-Forbes Psychological Services, LLC
• Lori Ann Kehoe, PT
• Angela Michele Kell

• Mental Health Counselor in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.